92 Decision Citation: BVA 92-04426
Y92
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 91-41 171 ) DATE
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THE ISSUES
1. Entitlement to an increased (compensable) evaluation for
pelvic inflammatory disease with urinary tract infection.
2. Entitlement to service connection for chronic bilateral
foot disability manifested by downward curving toenails.
REPRESENTATION
Appellant represented by: Disabled American Veterans
WITNESS AT HEARING ON APPEAL
The veteran
ATTORNEY FOR THE BOARD
P. M. Petersilia, Associate Counsel
INTRODUCTION
The veteran had active military service from September 1986
to July 1989. This matter came before the Board on appeal
from a rating decision dated in July 1990 from the Denver,
Colorado, Regional Office (hereinafter RO). The notice of
disagreement was received on August 15, 1990. The statement
of the case was issued on October 25, 1990. The substantive
appeal was received on November 9, 1990. A hearing was held
before a hearing officer at the RO in June 1991. A
supplemental statement of the case was issued on June 13,
1991. The appeal was received at the Board on August 26,
1991, and was docketed on August 28, 1991. The veteran has
been represented throughout her appeal by the Disabled
American Veterans. That organization submitted additional
written arguments to the Board on November 25, 1991, and the
claim is now ready for appellate review. The appellate
issues initially included one of a compensable rating for
back strain. A 10 percent rating was granted for the back
disorder in a June 1991 rating decision and there has been
no disagreement expressed with this grant, to date. We will
consider that claim satisfied.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran contends that she is entitled to a compensable
evaluation for her service-connected pelvic inflammatory
disease with urinary tract infection. She complains of pain
in her left lower quadrant and claims that this occurs every
three months during the middle of her menstrual cycle. She
has reported that the pain lasts 3 to 4 days and then
dissipates. Additionally, the veteran contends that she is
entitled to service connection for a chronic bilateral foot
disability manifested by downward curving toenails. She
argues that during basic training her boots were too small
and, as a result, the nails on her feet curve downward. It
is argued that service medical records confirm that she
received a temporary profile allowing her to wear tennis
shoes with her uniform while in service.
DECISION OF THE BOARD
For the reasons and bases hereinafter set forth, it is the
decision of the Board that the preponderance of the evidence
is against the claim for an increased evaluation for pelvic
inflammatory disease with urinary tract infection, and that
the preponderance of the evidence is also against the claim
for service connection for a chronic bilateral foot
disability manifested by downward curving toenails.
FINDINGS OF FACT
1. All relevant evidence necessary for an equitable
disposition of the veteran's appeal has been obtained by the
RO.
2. The veteran's pelvic inflammatory disease with urinary
tract infection is manifested by complaints of pain in her
left lower quadrant which occurs every three months for
approximately 3 to 4 days. Clinical findings are
essentially normal. On examination she was nontender to
cervical motion and there were no detectable masses nor was
there any tenderness over the right or left ovary.
Urinalysis was negative.
3. A chronic bilateral foot disability was not shown in
service.
CONCLUSIONS OF LAW
1. A compensable evaluation for pelvic inflammatory disease
with urinary tract infection is not warranted. 38 U.S.C.
1155, 5107 (1989) (formerly §§ 355, 3007, recodified in
1991); 38 C.F.R. Part 4, Code 7699, 7512.
2. A chronic bilateral foot disability, manifested by
downward curving toenails, was not incurred in or aggravated
during service. 38 U.S.C. 1131, 5107 (1989) (formerly
§§ 331, 3007, recodified in 1991).
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
Initially, the Board finds that the veteran's claims are
"well-grounded" within the meaning of 38 U.S.C. 5107(a).
That is, she has presented claims which are plausible. This
test having been met, we must examine the record to
determine whether the Department of Veterans Affairs (VA)
has any further obligation to assist her in the development
of her claims. After reviewing the record, we are satisfied
that all relevant facts with regard to the issues on appeal
have been properly developed and that the record contains
sufficient evidence for a fair determination. The veteran's
service medical records have been obtained and associated
with her claims folder; and she has been afforded a VA
medical examination for the purpose of disability evaluation
in connection with her current appeal. Post service medical
records have been obtained from her private physician as
well as from the VA. There is no indication that there are
additional relevant records which have not been obtained.
Accordingly, no further assistance to the veteran is
required to comply with the duty to assist mandated by
38 U.S.C. 5107(a).
I. Pelvic Inflammatory Disease with Urinary
Tract Infection
Disability evaluations are determined by the application of
a schedule of ratings which is based on average impairment
of earning capacity. 38 U.S.C. 1155; 38 C.F.R. Part 4.
Separate diagnostic codes identify the various
disabilities. When an unlisted condition is encountered, it
will be permissible to rate under a closely related disease
or injury in which not only the functions affected, but the
anatomical location and symptomatology are closely
analogous. 38 C.F.R. 4.20. Pelvic inflammatory disease
with urinary tract infection is rated analogous to various
gynecological infections and cystitis.
Service connection is in effect for pelvic inflammatory
disease with urinary tract infection, rated as
noncompensable under the provisions of Diagnostic Codes 7699
and 7512. Under the law, the evaluation assigned for this
disability is determined by a comparison of the
manifestations and symptoms of the disease to the relevant
schedular criteria. In order to warrant a compensable
rating, there must be evidence of residuals of infection.
Additionally, the veteran's service-connected urinary tract
infection is rated pursuant to the provisions of 38 C.F.R.
Part 4, Code 7512. Mild symptoms warrant a noncompensable
rating. In order to warrant a compensable rating of at
least 10 percent, there must be evidence of pyuria with
diurnal and nocturnal frequency.
The veteran's service medical records indicate that she had
a positive chlamydial culture at one point and subsequently
she had a probable yeast infection. A pelvic ultrasound
report dated in July 1989 was interpreted as within normal
limits and there was no evidence of ovarian cyst. Although
the veteran complained of extreme discomfort with the
urinary tract, there was only one documented episode of a
urinary tract infection during service.
On VA examination conducted in January 1991, the veteran
acknowledged that she had no vaginal discharge. Pelvic
examination appeared to be within normal limits. There were
no detectable masses nor was there any tenderness over the
right or left ovary. A urine culture and susceptibility
bacteriology report dated in January 1991 were negative.
We are cognizant of her testimony and of the fact that the
veteran complains of pain in her left lower quadrant which
occurs approximately every three months. However, in light
of the fact that there is no clinical evidence of residuals
of disease or pyuria with diurnal and nocturnal frequency,
we must conclude that the preponderance of the evidence is
against the veteran's claim for an increased (compensable)
evaluation pelvic inflammatory disease with urinary tract
infection. 38 U.S.C. 115; 38 C.F.R. Part 4, Code 7699, 7512.
II. Chronic Bilateral Foot Disability
Service connection may be granted for a disability that
results from disease or injury incurred in or aggravated by
service. 38 U.S.C. 1131. Service medical records reveal
that the veteran was seen in January 1987 for complaints of
"blisters" on her feet after being back from leave.
Examination of the feet was negative for blisters per se,
but was positive for multiple calluses with minimal
erythema. Calluses are caused by pressure and friction due
to, among other things, faulty weight-bearing and improperly
fitting shoes. Dorland's Illustrated Medical Dictionary
206-207 (26th ed. 1981); Current Medical Diagnosis &
Treatment 104-105 (1992). The veteran was placed on
physical profile due to painful calluses on her feet, and
was allowed to wear tennis shoes while in uniform.
Significantly, however, there are no records of additional
complaints involving the veteran's feet during her remaining
two and a half years of active duty. Furthermore, when she
was examined for separation from service, her feet were
normal.
On recent VA examination conducted in January 1991, the
veteran reported that the nails on her feet, specifically
toes 2, 3 and 4, curved downward and required nail trimming
or they would grow downward, making her shoes uncomfortable
to wear. It was noted that there were no specific reports
of ingrown toenails, infection or bleeding. We have
considered and given appropriate weight to her testimony.
However, its probative value is limited in light of the fact
that the examiner found that there was insufficient clinical
evidence to warrant a diagnosis of any acute or chronic
disorder or residuals thereof.
Hence, after review of the record, the Board concludes that
the evidence does not establish that the veteran suffered
from a chronic bilateral foot disability during service.
Specifically, there is no evidence that she has residuals of
calluses nor has she been diagnosed with a chronic foot
disorder. Accordingly, service connection for a chronic
bilateral foot disability is not warranted. 38 U.S.C. 1131,
5107.
ORDER
An increased (compensable) evaluation for pelvic
inflammatory disease with urinary tract infection is denied.
Service connection for a chronic bilateral foot disability
is denied.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
M. CHEEK H. STERLING, M.D.
HOLLY E. MOEHLMANN
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C. § 7266 (1989)
(formerly § 4066, recodified in 1991), a decision of the
Board of Veterans' Appeals granting less than the complete
benefit, or benefits, sought on appeal is appealable to the
United States Court of Veterans Appeals within 120 days from
the date of mailing of notice of the decision, provided that
a Notice of Disagreement concerning an issue which was
before the Board was filed with the agency of original
jurisdiction on or after November 18, 1988 (see sec. 402 of
the Veterans' Judicial Review Act (Pub. L. 100-687)). The
date which appears on the face of this decision constitutes
the date of mailing and the copy of this decision which you
have received is your notice of the action taken on your
appeal by the Board of Veterans' Appeals.